1194947416 NPI number — DEBRA BERNSTEIN PHARMD

Table of content: DEBRA BERNSTEIN PHARMD (NPI 1194947416)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194947416 NPI number — DEBRA BERNSTEIN PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BERNSTEIN
Provider First Name:
DEBRA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194947416
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1001 CAMDEN LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHAPEL HILL
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27516-7757
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-968-1167
Provider Business Mailing Address Fax Number:
336-570-3752

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7228 PITTSBORO-MONCURE ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MONCURE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27559
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-542-4991
Provider Business Practice Location Address Fax Number:
919-542-3726
Provider Enumeration Date:
05/03/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  15754 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)